Archives for 2024

Bowing to the — hopefully temporary! — inevitable.

The U.S. is struggling to mount an appropriate response to bird flu, and other pressing infectious threats, because we’re simultaneously ignoring and overlearning the lessons of COVID, @katherinejwu writes: https://t.co/YbbXkUXv7B

— The Atlantic (@TheAtlantic) April 30, 2024

Katherine Wu is always an excellent read, and this (IMO) is a good summary of the current status of H5N1 infection in the United States [gift link]:

… Because of the coronavirus pandemic, the nation’s alertness to infectious disease remains high. But both federal action and public attention are focusing on the wrong aspects of avian flu and other pressing infectious dangers, including outbreaks of measles within U.S. borders and epidemics of mosquito-borne pathogens abroad. To be fair, the United States (much like the rest of the world) was not terribly good at gauging such threats before COVID, but now “we have had our reactions thrown completely out of whack,” Bill Hanage, an infectious-disease epidemiologist and a co-director of the Center for Communicable Disease Dynamics at Harvard’s School of Public Health, told me. Despite all that COVID put us through—perhaps because of it—our infectious-disease barometer is broken.

H5N1 is undoubtedly concerning: No version of this virus has ever before spread this rampantly across this many mammal species, or so thoroughly infiltrated American livestock, Jeanne Marrazzo, the director of the National Institute of Allergy and Infectious Diseases, told me. But she and other experts maintain that the likelihood of H5N1 becoming our next pandemic remains quite low. No evidence currently suggests that the virus can spread efficiently between people, and it would still likely have to accumulate several more mutations to do so…

During this outbreak, experts have called for better testing and surveillance—first of avian and mammalian wildlife, now of livestock. But federal agencies have been slow to respond. Testing of dairy cows was voluntary until last week. Now groups of lactating dairy cows must be screened for the virus before they move across state lines, but by testing just 30 animals, often out of hundreds. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told me he would also like to see more testing of other livestock, especially pigs, which have previously served as mixing vessels for flu viruses that eventually jumped into humans. More sampling would give researchers a stronger sense of where the virus has been and how it’s spreading within and between species. And it could help reveal the genomic changes that the virus may be accumulating. The U.S. Department of Agriculture and other federal agencies could also stand to shift from “almost this paternalistic view of, ‘We’ll tell you if you need to know,’” Osterholm said, to greater data transparency. (The USDA did not respond to a request for comment.)

Testing and other protections for people who work with cows have been lacking, too. Many farm workers in the U.S. are mobile, uninsured, and undocumented; some of their employers may also fear the practical and financial repercussions of testing workers. All of that means a virus could sicken farm workers without being detected—which is likely already the case—then spread to their networks…

In other ways, experts told me, the U.S. may have overlearned certain COVID lessons. Several researchers imagine that wastewater could again be a useful tool to track viral spread. But, Sosin pointed out, that sort of tracking won’t work as well for a virus that may currently be concentrated in rural areas, where private septic systems are common. Flu viruses, unlike SARS-CoV-2, also tend to be more severe for young children than adults. Should H5N1 start spreading in earnest among humans, closing schools “is probably one of the single most effective interventions that you could do,” Bill Hanage said. Yet many politicians and members of the public are now dead set on never barring kids from classrooms to control an outbreak again…

The intensity of living through the early years of COVID split Americans into two camps: one overly sensitized to infectious threats, and the other overly, perhaps even willfully, numbed. Many people fear that H5N1 will be “the next big one,” while others tend to roll their eyes, Hanage told me. Either way, public trust in health authorities has degraded. Now, “no matter what happens, you could be accused of not sounding the alarm, or saying, ‘Oh my God, here we go again,’” Jeanne Marrazzo told me. As long as infectious threats to humanity are growing, however, recalibrating our sense of infectious danger is imperative to keeping those perils in check. If a broken barometer fails to detect a storm and no one prepares for the impact, the damage might be greater, but the storm itself will still resolve as it otherwise would. But if the systems that warn us about infectious threats are on the fritz, our neglect may cause the problem to grow.

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Stat’s @HelenBranswell talking about covid vaccine messaging and „The curse of the 95%“ now at @ESCMID #ECCMID2024 pic.twitter.com/IJ2zBEmBMV

— Kai Kupferschmidt (@kakape) April 27, 2024

The Great Pandemic Winding Down continues, for the moment. I’ll keep posting every week while we all wait to see what happens next…

Best Covid news I’ve seen in a while: US covid Hospital admissions are lower than they’ve been this *entire* pandemic! Week ending 4/20/24 is the 1st week we’ve had under 6000 new covid hospitalizations. Still a lot, and no this metric isn’t perfect, but this is good news. 1/3 pic.twitter.com/tc8EQ8MOCs

— Noha Aboelata, MD (@NohaAboelataMD) April 30, 2024

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COVID-19 Coronavirus (& H5N1) Updates: May 1, 2024Post + Comments (15)